Clinical Interventions in Aging (Sep 2021)
Integrating a Prevention Care Path into the Daily Life of Older Adults with Mobility Disability Risk: Introducing a Predictive Response Model to Exercise
Abstract
Leo Delaire,1,* Aymeric Courtay,1,* Mathieu Fauvernier,2,3 Joannès Humblot,1,* Marc Bonnefoy1,4,5 1Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de médecine du vieillissement, Pierre-Bénite, cedex F-69495, France; 2UMR CNRS 5558, Université Claude Bernard Lyon 1, Villeurbanne, 69100, France; 3Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Biostatistique – Bioinformatique, Pierre-Bénite, cedex F-69495, France; 4Inserm 1060-CarMeN, Université Claude Bernard Lyon 1, Villeurbanne, 69100, France; 5Université Claude Bernard Lyon 1, Villeurbanne, 69100, France*These authors contributed equally to this workCorrespondence: Leo Delaire; Aymeric Courtay 165, Chemin du Grand Revoyet Tel +33 4 78 86 39 46Email [email protected]; [email protected]: Exercise and nutrition are the best targets to tackle mobility issues in community-dwelling older adults. As exercise response relies on multiple factors, improving the understanding of their interactions is a necessity to tailor effective preventive strategies. Based on a prevention care path designed for community-dwelling older adults with mobility disability risk, our main goal was to determine the predictive factors of the response to a multimodal intervention, combining structured exercise training and nutritional counselling. Thus, this study aimed to tailor prevention programs for non-responder participants.Methods: We analyzed the response of participants to a prevention program and built a multivariate predictive model to highlight the profile of the best responders. The model was based on the likelihood of at least 1 point of short physical performance battery (SPPB) score gain. Inclusion criteria were being aged ≥ 70 years and having completed a multicomponent group-based supervised training consisting of 20 sessions (10 weeks).Results: A total of 103 participants were included, their mean ± SD age was 81.9 ± 5.7 years. The model demonstrated interactions between baseline SPPB score (OR=0.42; p < 0.001), body mass index (BMI; OR=0.82; p=0.003), and grip strength value (OR=1.15; p=0.008). The highest probability of response was found for participants with low SPPB, normal BMI (21 kg/m2), and high grip strength (27 kg).Conclusion: This study demonstrated that the response to a multimodal intervention in community-dwelling older adults with mobility disability risk was influenced by the baseline SPPB score, BMI, and grip strength value. To increase the proportion of responders, strategies that could be more effective include constituting more homogenous group, and implementing a specific approach for obese sarcopenic older adults and those with low grip strength by increasing the dose of physical activity and monitoring endurance and mobility activities between sessions. Our results provide important consideration for the development of targeted-interventions.Keywords: exercise, nutrition, prevention, responders profiles
